I took and successfully passed RC AP exam at the end of my forensic path fellowship. I did pass AP/CP in the States a year before in case you are wondering. First question people usually ask is “which one is more difficult”? There is no answer for that – you have to compare oranges with oranges. The exams are totally different and cannot be related (IMHO, of course). There is no “multiple choice” on RC exam. All answers should be written by hand (which drove me crazy since I type faster than write and my handwriting is pretty bad).

First part: 3 hrs written test, 26 questions with multiple parts. Some questions can be answered with a couple of words, for some a shot “essay” must be written. There were two forensic questions on this part, both were easy. There were plenty of molecular question this year (I hate this subject), and for some I had to invent answers. I don’t know if I got any credit for that:). I left 1.5 questions unanswered – there was nothing I could invent:). In spite of difficulties with writing (i.e., making my scribbles legible) I had time at the end and was adding extra stuff just for fun: for example, WHO grading of CNS tumors. We were not asked to do that but I was pretty bored.

Second part: 50 slides given in two portions in two hours: 25 slides per hour, and you have to share them with a “roommate”. The exam takes place on a campus of the college, and dorm rooms are converted into examination quarters; hence, a “roommate”:). Mine was pretty good – we didn’t bother each other. I had an hour left in total – slides were easy. Bad thing is that you cannot leave the room. So I was dozing in my chair under observation of a proctor, who clearly didn’t know what to do with me:).

Third part: images; 20 cytology, 20 forensics, 20 gross. 1 hour 20 minutes is given, and you can do them in any order. Images are in power point, but again all answers should be written down. Nothing esoteric was asked but some forensic questions puzzled me. After the test we discussed them with the Canadian grads (none of them is a forensic trainee) and discovered that we gave different answers for the majority of them. It alarmed me a bit since they were thinking like regular hospital pathologists and I have been corrupted by my forensic training. Later on I had a chance to chat with the guy (my future boss) who wrote them. It’s not a violation – he was eager to do this. Apparently, the entire new set will be produced for the next year, so it’s ok to discuss prior exam. According to him, he wanted to see how people of different background think. In other words, a question had multiple correct answers.

Last part (administered next day): oral test; it was quite entertaining. You have 5 slides to preview in 50 minutes (all straightforward) and think about related questions they might ask. I knew I would be safe as soon as I discovered two GU cases – that’s my hobby, and I know it cold. There was also a cervix with vacuities, a lung wedge and a colon resection slide. I had two friendly guys, who produced a number of additional images (i.e., EM, colloidal Hale stain, etc.) as needed. So it was pretty interactive. They did ask a lot of “quality control” shit, and even hated molecular questions. I navigated through this as best as I could and tried to compensate on topics I know very well (GU and non-neoplastic renal). At the end I had 40 seconds left and no questions to answer. We shook hands and that was it.

Now, the most interesting aspect: how the exam is scored. I’ve heard multiple rumors:

-        you should answer correctly about 70% of questions on the written part. That means you can safely loose 120 points

-        the slide part is the most important

-        if you do well on day one oral test doesn’t matter

-        if you screw up on day one oral test can help you to pass

-        if you are borderline on both a “FITER” is opened (it’s an evaluation form filled by you PD; compulsory to be registered for the rest). Mine actually is quite good – my PD has shown it to me

In reality I don’t know how much of the above is true. Before the exam I had two job interviews in Canada, and on both occasions I was told that the exam is “very fair”. I tend to believe it since I have passed:).

There are annoying parts of the exam (apart from handwriting – we could have typed like we did on CS test): BYOM (“bring your own microscope”) and tremendous waste of time on “sequestration”. You are not allowed to leave if you are done earlier. You will be kept in a room for hours before the slide part and after the oral exam. It drove me crazy. I like the ABP set up better – get the hell out of the testing center whenever you are done and come to the next part on time.

Speaking of microscopes: I had a real piece of junk, which I assembled out of two at the beginning of my fellowship. I use it for everyday work, although it doesn’t focus well and has only 3 objectives (5x, 10x, 40x). Other people made fun of me: they had 20.000 dollars piece of equipment from their residency programs packed in fancy trunks. I brought mine in a beer box:). Bottom line: don’t be intimidated by other folks. Do your stuff and it the end it won’t matter as long as you pass. Same thing is true about dressing up for the oral part. There were only few of us in “all stars” trainers but “it’s not an examination in footwear” ©. If you don’t want to put a suit on – don’t. It doesn’t matter. Impress them with your knowledge:).

A couple of words about preparation. I did NOT prepare the following: slides, forensics, gross images. I did look thought cytology images (me co-fellow keeps all her residency books in the office), I went though Osler 2011 and ASCP 2010 and I read several times a set of remembrances from past exams (some of them were in French:)). If you don’t want to read Robbins, don’t read it. I didn’t. I hate this book. There was plenty of stuff from Robbins in the recalls I obtained (as indicated by the authors).

That’s all for now. If you have questions, feel free to ask.